Active NPI
Primary Care West, S.C.
- Health Service Clinic/Center
- Aurora, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- License
- 042617613
- Legal business name
- PRIMARY CARE WEST, S.C.
- Practice address
- 1300 N Highland Ave
Suite 2
Aurora, IL 60506-1451 - Phone
- (630) 897-9606
- Fax
- (630) 897-9625
- NPI assigned
- Jan 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dave Mante, M.D.
- Title
- President
- Phone
- (630) 897-9606
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | 042617613 | IL | Primary |
Addresses
Primary practice location
1300 N Highland Ave
Suite 2
Aurora, IL 60506-1451
Mailing address
1300 N Highland Ave
Suite 2
Aurora, IL 60506-1451
Phone (630) 897-9606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Primary Care West
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Medicine Physician
- Aurora, IL
- NPI 1750575940
Locations
1300 N Highland Ave
Ste 2
Aurora, IL 60506
Phone (630) 897-9606
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Aurora, IL
- NPI 1487701082
-
- Adult Medicine Physician
- Aurora, IL
- NPI 1427105022
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1296691200000",
"number": "1154478766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 N HIGHLAND AVE",
"address_2": "SUITE 2",
"city": "AURORA",
"state": "IL",
"postal_code": "605061451",
"telephone_number": "630-897-9606",
"fax_number": "630-897-9625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N HIGHLAND AVE",
"address_2": "SUITE 2",
"city": "AURORA",
"state": "IL",
"postal_code": "605061451",
"telephone_number": "630-897-9606",
"fax_number": "630-897-9625"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIMARY CARE WEST, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-04",
"last_updated": "2011-02-03",
"status": "A",
"authorized_official_last_name": "MANTE",
"authorized_official_first_name": "DAVE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "630-897-9606",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": "IL",
"license": "042617613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.